It’s a rare luxury when I have a Tuesday off work and can actually watch The Good Doctor leisurely over breakfast — more so after just coming back from a mini vacation that was a much needed change of pace and scenery.
I still kinda wanna throw things at the television for being cheated out of the Good Stuff™, but not with as much force as last week. I wanted my money back then, and I still do now, but we got some other Good Stuff™ instead this week, so maybe I’ll settle for a discount code.
And how is it that these recaps are becoming longer and longer by the episode? So far, season 5 is the bee’s knees. I’m loving it. Carry on, writing team. You’re doing well.
Written by Adam Scott Weissman & Thomas L. Moran
Directed by Anne Renton
Original airdate Oct 11, 2021
Patient #1 is an unnamed man brought into the ER that Shaun and Asher tend to. (I believe Salen later refers to him as Bob.) Bicycle accident with severe facial trauma. He’ll need extensive reconstruction of his facial bones, and both Shaun and Asher get excited over the three cool surgeries that are suddenly on the agenda. The paramedics bringing the guy in think that’s in poor taste. One of them punches the ‘unhappy’ smiley on the client feedback machine thingy on his way out.
Shaun clears the surgery with Dr. Lim, but Salen challenges the profitability of it. The patient is being offered the gold standard of bone reconstruction, but he only has aluminum insurance. She tells Audrey that Ethicure can only offer what’s covered by insurance, and this surgery clearly isn’t. Salen’s only invested in offering improving healthcare for people who make responsible choices. Like investing in premium insurance rather than expensive European road bikes. Ugh. Yeah. It’s all about $$$ again. Can’t say I’m surprised.
Jordan has a pretty good idea to combine two of the surgeries so that it would save them almost 90k on skipping the third operation. They could use the saved money to cover the cost of the polyetheretherketone (or PEEK, for short) implant. Lim likes the approach, too!
Things become more pressing when the patient goes into haemorrhagic shock because of wound infection. Shaun, Asher and Jordan try to brainstorm ideas. Seems like combining the surgeries won’t work now because the risk of repeated haemorrhagic shock is too great.
The team tries to come up with better ideas, and once again it’s Shaun’s brilliant mind that finds the perfect solution, which is also covered by insurance. He suggests they create an osteomyocutaneous flap (likely from the scapula bone of the shoulder, as depicted in one of Shaun’s mind palace scenes) so that he won’t need the PEEK implant. We don’t see the patient again after this, so we can only assume the surgery goes well and the facial reconstruction with a piece of bone rather than the synthetic implant was a success.
Patient #2 is Jenna Delacruz, a woman with severe refractory epilepsy. Before she received a brain stimulation implant, she had over 50 seizures a day. She hasn’t had any seizures at all since the implant was inserted, but the device was an experimental prototype and didn’t work as well for other patients, which made it unprofitable. The company who made it decided that they will no longer support the software and is requiring that it be removed. Man, that’s brutal.
And yes, this can happen. Is it ethical? Not particularly, and I’d like to think that if a company truly had patients at heart, they’d keep offering the device in a compassionate use program on a case by case basis. The Good Doctor writers called taking the experimental device out evil, absurd and capitalist. Can’t say I disagree. It’s always a fine line to walk, and not an easy decision for any company in this position.
Now please excuse me while I go into teacher mode and venture into a short educational foray into epilepsy. You can skip the parts in purple if you’re not interested in that stuff.
Interestingly, I can actually rattle off a bit of information on epilepsy right off the bat. About 50% of epilepsy patients respond to first line treatment, which is usually one of the gold standard anti-epileptic drugs (AEDs). Those that don’t respond get a second AED added to their treatment regimen, and in about another 50% of cases, that stops or significantly reduces seizure frequency.
For the rest of the patients, you then start to cycle through available AEDs and treatments. There’s a lot of trial and error with adding AEDs, perhaps taking some away (which physicians are often reluctant to do) and replacing with something else. It’s tricky, because it’s not uncommon that, when you stop taking an AED that has worked before, and you restart it later, it won’t work anymore. There are patients who are on combinations of as many as seven or eight AEDs at the same time, and are still not seizure free. AEDs all have more or less significant side effects, sometimes those that are personality altering or increase the risk of suicidality.
Alternative treatments to medication can be implants that get inserted into the skull that deliver electric stimuli to certain brain regions when the beginnings of a seizure are detected, which is what Jenna has in her skull. There’s only certain types of epilepsy where this type of treatment can work, but it can be very effective.
One of the last lines of treatment is to actually remove parts of the brain, but again there’s only a subset of patients where this is even an option. When I first learned about this, I found it quite shocking that brain regions as big as a person’s fist can be removed in epileptic patients, and it wouldn’t necessarily impact the person’s body or brain functions. The brain is an amazing sometimes crazy scary organ.
Not that any chronic illness is ever fun or cool or desirable, but epilepsy really sucks. Because seizures are unpredictable. You never know when they come, what you’re doing at the time, how bad they will be, or how they will affect you. That can cripple people’s lives, potentially render them unable to work or commit to social activities. Having a grand mal seizure in public is often humiliating, and can lead to unnecessary hospital stays.
Not all epileptic seizures are what people typically associate with epilepsy — which is what is classified as grand mal (or tonic-clonic) seizure. You know, those where the patient goes down, becomes unresponsive and starts twitching. Those usually happen when the whole brain is involved in neurons misfiring and causing a generalised epileptic seizure.
However, there are also other forms of seizures. Some of them only affect smaller, confined parts of the brain, which can cause just a limb to twitch or jerk, or the face to contort, or strange noises being uttered. Some seizures can cause loss of muscle tone without twitching. Some can be people just staring off into space for an extended time (these are called absence seizures).
If you ever come across someone having a tonic-clonic seizure, you don’t necessarily have to call an ambulance right away, though of course it’s not wrong to err on the side of caution. Young Epilepsy in the UK has a pretty good infographic that gives some helpful guidance. All right. Lecture over, back to the episode.
To help Jenna, Mateo suggests a surgical approach to remove the seizure focus (i.e. take out affected and damaged regions of brain tissue). It’s risky, and could leave the patient with mental or physical deficits. Mateo doesn’t quite verbalise it very eloquently, but Marcus likes the idea, even if it was presented poorly. Guess Mateo dodged a bullet there.
Salen is the one who brings the brain surgery to a screeching halt. Even though the patient’s insurance has approved the surgery, she wants the surgeons to run it past the legal department. It’s a precarious surgery and could be a liability risk for the hospital.
Side note: This has been discussed on Reddit before, and I’m not sure there’s a good answer for this. Why are all the attending surgeons on the show doing all kinds of surgeries? Don’t you have to specialise at some point, and then you do only those types of surgeries? It seems that both Andrews and Lim are doing everything all the time. Clearly, this epilepsy patient would be a case for a neurosurgeon (like Glassman). Is Andrews a neurosurgeon? Nope, his specialty is cosmetic surgery. Is Mateo a neurosurgeon? I don’t think so either. Why are they even doing this surgery themselves?? (I think the answer is ‘creative license’, but that’s not a good or satisfying one.)
Andrews hates Salen’s boundaries as much as the next guy, but he has ideas how to cut through the bullshit and get them their desired result. He’s gonna work some more on Salen to get her on board rather than antagonise her.
When they try to map Jenna’s seizure focus, they realise that it’s not just one, it’s actually four. Which makes the surgery even riskier, and that’s not good.
Andrews fights for the surgery and bargains with Salen, getting them what they’re asking for. Jenna’s implant is removed, and they can do their complicated miracle surgery. Which goes well, and Jenna wakes up (so far, so good) seizure free. Happy ending for her, fingers crossed.
Side note: I guess this is another thing ticked off the season 5 wishlist. One of the wishes was to see the show break more frequently with the classic patient case structure, and this one, in a way, did. Yes, we still had the regular two patients, but there was actually very little focus on the patients themselves. Only one of them got a speaking part, and even that was merely exposition.
And you know what? I loved it. There was so much more time to focus on the main characters of the show, to give them growth and development and explore their backstories, rather than bothering with establishing some complicated personal patient story of a character we would never see again.
Don’t get me wrong, I’m not saying the patient stories are superfluous or pointless. But sometimes I wish we had more episodes like this, where the primary focus is on the main characters and less so on the two patients.
Shaun & Lea
Lea is lying in bed, waking up from a noise she heard. Judging from the murky light, it’s still very early in the morning. She sleepily blinks, there are subdued noises from the living area and Shaun’s side of the bed is tellingly cold and empty.
Lea finds him in at the dining table, printouts of articles spread all over it. Shaun has Steve’s old bookmark at the ready, his little grey notebook is filled with new scribbles, and there’s a half-empty glass of orange juice on the table. Clearly, he’s been at this for a while, whatever ‘this’ is.
Minor gripe: Lea’s hair is surprisingly perfect for the fact that she just slept on it for a whole night. Shaun’s, however, looks adorably tousled. I love their little domestic moments like this. They always plant a happy smile on my lips.
Lea asks Shaun if he’s okay, and he proudly announces he’s stamped and addressed all the Save-the-Date cards for the wedding. He has a pile of envelopes to show for, and I’ve tried to roughly count them from the screenshots. (Nerdy, I know.) Should be somewhere in the 70 to 80 range. Lea tells him he could have waiting until he had a day off, but Shaun says he couldn’t sleep.
While we didn’t get to see the immediate aftermath of Shaun’s air dryer meltdown from the previous episode (I’m still super mad and I will be writing ALL THE FAN FICTION), but this inarguably demonstrates how much the disruptive Ethicure crap is affecting Shaun, keeping him up at night.
“I know change is hard for you,” Lea tries to reassure him. “Salen’s changes are not hard because of my ASD,” Shaun counters. And, wait, what? Are you sure, Shaunie? Cause I’m fairly certain that has a lot to do with how much you’re struggling right now. “The new soap, hand dryers and scrubs are all inferior to what we had before. Now I have to bring my own soap and paper towels.” And he shows them to Lea, all neatly packed in a travel baggie, for good measure.
Lea tells Shaun she’s seen him adapt to change before. Like the toilet paper. Or how she cuts avocados. (How do you cut an avocado? Can’t say I’ve ever done it, I don’t like avocados. How does Lea cut one, and how does Shaun think it should be cut? Is it slices versus dicing? Or how you cut it open? Inquiring minds want to know!) Cute little detail, Shaun actually looks over to the kitchen when Lea mentions avocados. Weird, random thought: Can we petition to get Shaun avocado socks? H&M sells them. The dark blue ones are really nice.
All the articles Shaun has compiled are evidence that Salen’s changes are unfavourable or detrimental, and he plans to show them to her. He has clearly understood that Salen is all about data, but Lea cautions him against it, or at least consider a different viewpoint. Because right now, Shaun seems to be the only person having such a huge issue with the changes, and Lea recommends that Shaun first check with his colleagues on their stances and opinions. “To get Salen to change her mind, you need to think about what’s important to her, not you.”
That’s actually good advice, and Shaun realises it, too. He thanks Lea for the pointer, and Lea thanks him for helping with the envelopes. She will mail them out today. They’re both excited for the wedding. And Shaun gets an endearing little kiss out of it.
What we’ve learned from this scene:
- The wedding is now two months away, so they’ve definitely set a date. I guess timing-wise, that means it’s likely we’ll see the wedding as the winter finale, or somewhere mid-season. That makes perfect sense to me, and I’d like to think I’ll be happy with that.
- Shaun has actually studied wedding planning books. And apparently they say you should mail out Save-the-Date cards 4-6 weeks in advance.
- Shaun has either alphabetised the envelopes by first name, or sorted them by importance of the guest, because Dr. Glassman is at the top of the pile. As per the envelope, the house number is 2105, the street Deia Drive (which doesn’t actually exist in San Jose as per Google Maps), and his ZIP code is 95112. And that’s a continuity error right there, because the house number on Glassman’s house is actually 1570.
- Salen owns several hospitals, and somehow Lea knows that she uses the same setup and equipment there as well (like the soap, scrubs, etc.) and the staff apparently likes them. Has she done research? Has she asked around? Has she gone there?
During the day, Shaun keeps inquiring with colleagues how much they like or don’t like the changes that Salen has introduced, most pressingly the new soap and hand dryers. Jordan likes the new soap. Asher didn’t even notice there’s new soap. Asher also doesn’t share Shaun’s concerns about the air dryers spreading germs and doesn’t think it wise of Shaun to talk to Salen about the hand dryers.
Lea goes to mail the wedding invitations the next day. When she takes a look at the addressees, one in particular catches her eye. Marcie Murphy in Casper, Wyoming. That’s Shaun’s mother.
I may have uttered an, “A-ha!” out loud at that moment, because fans have been speculating whether Shaun would invite Marcie to the wedding or not. Interesting!
Lea looks at the envelope for a few, long seconds, then decides not to mail it. She stuffs it into her bag, to raise the topic with Shaun later.
Side note: Apparently, Shaun and Lea live on the same street Glassman does — 327 Deia Drive, Apt. 24. Kinda explains why Shaun just goes see Glassman every now and then. He can probably just walk there, though I’m not sure just how much of a distance 1778 house numbers might be in San Jose.
Another side note: Why is Glassman’s envelope not at the top of the pile anymore when Lea mails them? Clearly, I’m putting too much thought into this.
This next scene is both almost comical but also kinda tragic at the same time. Shaun bursts into Dr. Glassman’s office with a request for advice, as he is wont to do, but there’s no Glassman. Which Shaun only realises mid-sentence. Glassman’s new assistant comes running after Shaun. “Can I help you?” Shaun asks where Nicole is. She was reassigned and Ellen is now Aaron’s new executive aid.
Shaun’s isn’t impressed. (Understatement!) When Ellen asks if she can take a message, Shaun starts rattling off his problem in record speed. “Salen told Dr. Lim everything we do needs to be covered by insurance, so Dr. Lim told me to prep our patient for his first surgery while she tries to get the polyetheretherketone implants covered.”
Ellen asks how to spell polyetheretherketone, and Shaun elaborates, “Okay. Dr. Glassman needs to change things back to the way they were before.” Well, yeah. That’s what everyone wants, Shaun. But that ain’t happening, my boy. You’ll be in for quite some disappointment if you keep wagering your money on that.
It’s kinda cute when Ellen asks who he is, and Shaun goes, “Dr. Shaun Murphy. Dr. Glassman will know if you just say ‘Shaun’.” 😀 (Wanna bet she spelled it Sean, even though he’s wearing his lab coat with his name on it?)
What’s curious is that Lea actually chooses Morgan as the first person to talk to about the Marcie letter. She explains to Morgan why it could be an issue, and why she’d rather not have Marcie at the wedding. (Probably a welcome opportunity for exposition for those viewers who might not recall the season 3 episode Friends and Family where Shaun’s father passes away.) Lea is afraid Marcie being there will cause conflict at the wedding. “I want the day to be about our future, and not the past. I don’t wanna reopen old wounds and risk him melting down right before I walk down the aisle.”
Lea recognises it’s a selfish notion, but Morgan tells her that it’s okay to be selfish when it’s about your wedding day. Lea knows she should talk to Shaun about it, but he’s already so stressed with the whole Ethicure situation. I absolutely love Morgan here, I like this softer side of her. “You’ve never handled Shaun with kid gloves. No need to start coddling him now.” Yep, I’m with Morgan on this, but I also get where Lea is coming from. Tricky.
When Morgan asks Lea about her farting problem, Lea actually overshares a blast from the past. “When I first moved in with Shaun, I convinced him to order in Atomic Wings, and I got terrible diarrhea. But Shaun prescribed the perfect mixture of Pepto and ginger root. It was disgusting, but I was also totally vulnerable, and that can be a turn-on, too. Not in the moment. Long-term.” Ah, Lea, I get you. It’s all about the hurt/comfort. Yep, totally with you there.
Lea tries to catch a moment with Shaun in the surgeon’s lounge. He’s still studying journals to seek inspiration for the facial reconstruction surgery. He seems distracted. Lea starts talking about the Save-the-Date cards, but Shaun’s mind is clearly not with it. He tells Lea about the PEEK implant. “Shaun, could you take a break for just a minute?” she gently asks him. He lets out a breath, tries to listen. But, nope. Won’t work.
“Everything is worse. The dryers are loud and distracting, the soap smells terrible, and I can’t properly repair my patient’s face.” He gets all agitated and fidgety, and Lea knows now is not the time to talk about Marcie. She takes his hand. “Hey. You’re brilliant. You’ll figure it out.”
I can only admire Lea’s patience with Shaun. This is one of those moments where she knows she’ll have to put him first over her own issue. And she does. Remember when Shaun talked to Lea’s parents about him teaching her patience in 4×08 Parenting? This is exactly one of those moments. And it’s beautiful, and I want to hug her. This is why Shaun and Lea are made for each other, even though the road was a bit rocky at times.
Remember when I said last recap that Shaun better start wearing t-shirts underneath the new scrubs? Well, he took it a step further and is wearing long underwear. And he’s sweating profusely during surgery with all those layers. Asher and Jordan like the new scrubs, particularly how they look.
Shaun’s irritation with the scrubs and the soap and the air dryers is becoming a bigger problem. Shaun is short-tempered and it messes with everything, including his ability to teach Asher and Jordan. Whatever bug crawled up Asher’s arse that day (re: the constant attacks on Jordan for her Christian beliefs), he now jabs at Shaun for constantly fussing about the scrubs and the soap and the bathrooms, too.
All the props to Jordan for taking a stand for Shaun. “Nice, Asher. Trivialize his autism, because you haven’t offended enough people.” Shaun adds, “ASD doesn’t make me irrational, the changes are objectively worse, okay?” And I love that Jordan sincerely apologises to Shaun right there.
Things come to a head when Shaun flees the surgical prep room just as they’re about to scrub in. Wearing long underwear isn’t the solution, and he can’t tolerate the new scrubs on his bare skin. He strips off the scrub shirt in the locker room and goes to his mind palace, nearing the bone reconstruction solution, but then another physician starts using the hand dryer near him, and Shaun is ripped right back to meltdown territory.
His nerves are stretched too thin, and whatever resilience he might have left is likely spent on not curling up on the floor and instead putting his pants and shirt back on, gathering his research and running right to the server room where Lea is in the middle of a conversation with Salen.
Shaun’s hair is all messy, his shirt is crumpled and untucked, and he goes off on an impassioned tirade without any filter at all. He stands in front of Salen, all upset and riled up, rattling off all the reasons why the Ethicure changes are ill-advised, thrusting folders with printouts into her hands. Lea sees this and tries desperate damage control, but it’s too late now.
“American Society of Microbiology, Mayo Clinic, Clinical Microbiology all show the use of paper towels results in lower rates of contamination than jet air dryers, and foaming soaps are less concentrated, which reduces effectiveness, added fragrances increase allergic reactions, and synthetic fabrics can be abrasive and contribute to microplastic pollution. You made these changes without asking us first, because you’re not trying to help us, or protect patients, you’re doing it to save money, and it’s wrong. You’re wrong. You’re wrong!”
You gotta admire Shaun’s vigour and passion. And Freddie Highmore’s skill at recalling and reciting lines at ASD record speed. 🙂
And as much as we all wanna hate Salen, she’s actually handling this whole situation with admirable grace and composure. She listens to Shaun, truly listens, and neither dismisses nor invalidates his concerns. This scene is packed with so many noteworthy things, and I don’t even know where to start.
Initially, the predominant emotion that an agitated Shaun running in to confront Salen provoked in me was a sense of dread. Because, oh shit, Shaun just venting without restraint is not gonna go down well! Lea trying to placate him clearly wasn’t gonna work at this stage of upheaval.
All the more amazing that Salen reacts so calmly and collectedly, and that she easily understands Shaun’s point of view and agrees with him. Not gonna lie, on the first viewing I loved how this whole conversation went, and I wanted to fistbump Salen right there. Then of course, once you know the ending of the episode, there’s a whole lot more to unpack. Because, Salen, you sly bitch! She’s a cunning little trickster, isn’t she?
Salen perfectly knows how to navigate Shaun’s autism, knows the exact right buttons to push to instantly calm him down, to plant his feet firmly back on the ground. Shaun very often sees things very black and white. You’re either wrong or you’re right, and there’s data somewhere that will corroborate what’s wrong and what’s right. When Salen stumps him with saying they can have opposing views, but they can both still be right — that confuses Shaun.
What’s notable here (and maybe I’m reading too much into this), when you go back to the very first scene of the episode, Shaun adamantly tells Lea, “I’m not wrong,” when she starts challenging his approach how to confront Salen on the Ethicure changes. He comes back to the ‘my data says I’m not wrong’ approach with Salen right here, which I think was a nice callback to that first scene. And it shows that maybe Shaun is not always right, or that right or wrong can change, depending on the context.
Also related to the first scene of the episode, remember how Lea tells Shaun that to get Salen to change her mind, he needs to think about what’s important to her and not what’s important to Shaun? He smiles and says that is good advice. Yet, did he take any of that advice? I think the answer has to be no, because when he lists off all the reasons why Salen’s changes are bad, none of it is about what’s important to Salen, and all of it is about what’s important to Shaun. That’s curious, isn’t it? Shaun is usually all about taking advice from others and applying it in his own way. What went wrong in this instance?
To assuage Shaun’s confusion, Salen outlines why they can both be right, and it makes a certain kind of sense. She easily acknowledges that Shaun has special needs and then acquiesces to cater to them. Ostensibly without asking for any trade-off, but we later learn that wasn’t quite true, was it?
If you look very closely, the moment she tells Shaun that she will concede to his demands “because some doctors are different”, she pauses and writes something down on her tablet. Make a mental note, I’ll come back to this later.
What I also love is how Shaun immediately fends off Salen’s remark towards blaming his ASD for his outburst. She explains, “Your ASD gives you a unique—” Shaun interrupts her. “No. No, thank you, it’s not my ASD.” This is a really sore point for him, which drives home the irony of episode’s ending even more.
Salen has all the right words for Shaun. “I was going to assure you that I’m not dismissing you. I value your unique perspective. Cause my ADHD gives me a unique perspective. You could be a great asset to this hospital, but only if I’m able to recognize that one size may not fit all.”
It’s kinda cute that Shaun immediately takes this literally and remarks it’s not the size of the scrubs that’s the problem. Makes me smile right there. Salen also can’t quite hide the amused smile flicking across her face at the remark. “I’ll have maintenance put back the old soap and paper towels in the residents’ locker room and break room. And you can go back to wearing your old scrubs. But just you.”
So there I was, initially filled with dread at Shaun storming in with the outburst ready to boil over, and then filled with admiration of how well Salen handled the situation, oscillating to a sense of joy of Shaun getting back on track when he’s allowed to go back to his old scrubs and soap and paper towels. The relief for him is so tangible (I love his little alleviation exhales), and Lea sees it too — please take note of her satisfied smile as she studies Shaun’s reaction to Salen’s concessions.
What I can’t quite figure out, though, is Shaun’s brief staring-into-space escapade here. This was one of his mind palace moments without animations to visualise his process, right? The music and Shaun’s demeanour suggest exactly that, as does the scene that follows, but why omit the visual effects? Did they run out of VFX budget? Did they want to shake it up and have the viewer see the perspective of an unknowing bystander rather than let us get a glimpse at Shaun’s process? It puzzles me a little.
That said, this once again illustrates just how much stressors and distraction interfere with Shaun’s savant syndrome. He wasn’t able to solve his surgery conundrum with all this trouble and anxiety chasing him round every corner. And now that Salen took all of that away, he can single-track focus on the medical problem at hand and solve it in one fell swoop. Shaun’s mind is amazeballs. And the self-satisfied, happy little smile on his face is adorable when he utters his tell-tale, “I have to go.”
But let’s rewind to the beginning of this scene for one moment, just to note that it’s kinda cute that Lea assumes the reason why Shaun is breezing into the server room is that he wants to talk to her. “Shaun, I’m kind of in the middle of something…” Far from it, he’s not there for Lea. Which of course she soon realises.
Jorg on Reddit remarked to me that “the outburst was a hell of an acting performance in itself”, and I can only whole-heartedly agree. Not just on Freddie Highmore’s part, Paige Spara and Rachel Bay Jones all truly shone in this scene, with the reactions and facial expressions and dialogue absolutely on point. I have so much admiration for these two minutes, as showcased by the fact that I’ve written over 1,300 words about this scene alone (which equals about two A4 pages in font size 11). Much love, guys. You rocked this one. And much love also for casting Rachel, she’s a perfect Salen.
Okay, let’s move on from that epic server room scene that took over this recap, and on to another favourite in this episode. Because… karaoke! Yay!
Apparently they decided to go to a karaoke bar for their little celebration/make-up outing after their successful surgery. Asher and Jordan are giving their all on a rendition of Ain’t No Mountain High Enough, and Shaun turns to Lea in the background and proposes a toast. To him. “I had faith in myself, spoke my mind, and got everything I asked for.” (Careful what you wish for, though. Cause you actually got more than you asked for. And not in a good way.)
Lea is proud of Shaun, and rightly so, although the credit for his success is mostly to be given to Salen and not to how “well” Shaun presented his arguments. Shaun better enjoy his little triumph as long as he can, because neither of them know yet what he has coming for him. This toast is very bittersweet when you already know how the episode ends.
Lea chooses the laid back listening-to-karaoke moment to raise the topic of Marcie’s envelope again. “Shaun? I didn’t mail the Save-the-Date card to your mom. Because I don’t wanna invite her. I feel like you two still have a lot to work through. Which you should, but I want our wedding to be fun. I don’t wanna complicate it with any pain from the past.” And Shaun explains to Lea why he put her on the guest list. “The wedding books said I had to invite her. Were they wrong?”
Well… yes. Maybe. In your case, Shaun, I daresay yes. Lea seems to agree. She asks him if he would be okay not having Marcie at the wedding. “Yes. Very,” Shaun says. Okay, case closed.
Am I assuming correctly that they booked a private karaoke room for this one? Love that idea, and yay for more karaoke. Another bullet partially ticked off the season 5 wishlist. Because I wanted Shaun karaoke. We got karaoke, but no active Shaun singing action. Which is okay, we’ll just have to imagine the mind-movie version of it in our heads. I’m just happy Shaun and Lea got more karaoke opportunities. Leave me a comment to tell me what song you think Shaun and Lea got to perform that night, slightly tipsy on tequila, stat.
On the topic of Marcie, hm. I’m honestly not sure what to make of this. Fans have been discussing whether Marcie would or should be invited to the wedding and/or be at the wedding. I guess that question has now been answered. Many of us assumed (or hoped?) that, if the issue were tackled, it would be handled a bit more poignantly than this. Seems like a missed opportunity.
There was also criticism as to whether Shaun would be smarter than to have some wedding book make a decision about inviting his estranged mother to the wedding without discussing it with anyone first. He’s usually the first person to seek advice about things that he’s unsure about or that feel off to him. Would Shaun not question whether it’s a good idea to invite Marcie to the wedding? Enough to prompt him to at least mention it to Lea? I mean, she was right there in Casper, she saw the ugly disaster that is his family.
On the other hand, Shaun often sees things very clear-cut, and he takes things literally and at face value. If the wedding books say that parents are a must-have on the guest list, then he might not question that, particularly with the deficits he has around certain social situations and structures.
I’m a bit torn on this, if I’m being quite honest. But if I had been asked for my preference, my clear choice would have been to make this a more profound discussion than what felt like a throw-away “some book said I should do it” explanation. Oh well…
Salen and Ethicure
Salen and her profit driven approach are still hella annoying. And Ethicure has more unfavourable changes in the works. Apparently they’re shrinking the chapel to make room for VIP birthing suites.
Salen is still kinda everywhere. Even if she has an office, she’s never there. She showers at the hospital, she works from the cafeteria or the nurse’s desk, she seeks out everyone and watches everything. Sure, some of that is likely her ADHD. And it’s also what makes her an effective boss.
In a conversation with Lim about why she can’t authorise the three facial reconstruction surgeries, she explains, “Pursuit of profit drives innovation. Innovation creates the treatments that you and I both want, and our clients need. Sucks for Bob, but the more money this place makes, the more people we can help.” And you know what? Salen is actually right about the innovation piece. It’s incredibly difficult to innovate without investment. I know this from experience.
Like I said, it’s hard to despise Salen for what’s she’s trying to do here. Some of her ideas and principles aren’t that wrong, but the execution is lacking. She will need to find a middle ground eventually. I’m truly curious how this is going to keep playing out. And how many figurative (hopefully not literal) bodies will be littering the path in her wake.
What we learn in this episode is that Salen is very much a quid pro quo girl. Glassman saw it early on when he bargained with her about his puppet role. Andrews successfully utilized that approach when he got himself and Mateo their brain surgery. That’s a valuable thing to know, for sure.
But now on to the big doozie. “Some doctors are different. Some hospitals, too.” The huge Dr. Shaun Murphy banner at the very end of the episode.
Like, holy crap. I can’t wait for the fallout of this. Because what we all know with a 100% certainty: Shaun did not give permission for his likeness to be plastered across the city in billboard size as a (literal) poster boy for Ethicure, especially the fact that it advertises he’s on the autism spectrum.
And you know what? This is actually illegal. While it may not be completely out of the question there’s some clause in Shaun’s employment contract that images of him may be used for promotional purposes, it very clearly is not allowed to disclose someone’s disability publicly without their consent. And this is as big a violation of that as they come.
So what does that mean? We know Shaun will not be happy (understatement again) about that dick move on Salen’s part. What will he do, though? Can he threaten her with legal action to kill that promo campaign? Can he sue her? Will he sue her? And if he does any of those things, what consequences will that have?
Salen knows she has leverage. She can make Shaun’s life at St. Bonaventure a living hell, all the while staying within legal boundaries. She knows his vulnerabilities, and we know she has no qualms shamelessly exploiting them for her own gain. Shaun’s gonna be in a real quandary, and I’m kind of excited to see how this will play out. What a mini cliffhanger!
This also explains why Salen so easily agreed to let Shaun have his way with the scrubs and the soap and towels. She had an agenda, and she fed Shaun the carrot so that he wouldn’t buck her off as violently as he might have otherwise. Quid pro quo indeed, only this time in a very twisted manner. I’m kinda loving her cunning. I need to see where this goes! Is it next Monday yet? (Welp, actually Monday after next, since apparently there’s no episode on Oct 18. Crap.)
Oh wait, I said I would come back to this, right? Remember during the server room tirade scene, Salen jotted something down while she was talking to Shaun? Shaun was saying they can’t both be right, and Salen says, yes, they can. “Because some doctors are different, and sometimes…” And then she takes notes. Now look at what the banner says.
Salen, you conniving little bugger. I’m kinda impressed, though.
This episode had a number of callbacks to older episodes, and the banner is one of them as well. In 3×14 Influence, there’s a sub-plot of Shaun being asked to give an interview about being a surgeon with autism to inspire other people. He goes back and forth on it for a while, but in the end he declines, telling Dr. Glassman, “I considered all the arguments. I want to be known as a good doctor, not a good autistic doctor.”
We can only assume Shaun’s stance on this hasn’t changed, particularly since he immediately tried to shut Salen down when she suggested that his autism was the reason why all the changes were upsetting him so much. So yeah, Shaun learning next episode about Salen using and abusing his autism status for promotional purposes will certainly be… interesting.
Nerdy observation of the week: The banner of Shaun outside hospital depicts Shaun mirrored, and I can’t figure out why. Look closely. Shaun always wears his watch on his left arm. It’s on his right in the image. Shaun wears his hair parted on the left, it’s parted on the right in the image. The embroidery on the St. Bonaventure lab coats has always ever been on the left side, it’s on the right side in the image.
I know this is incredibly nitpicky, but the image editing geek in me wants to know why the mirroring when it’s not even necessary? The only reason I can discern as to why they would have done this is that they used an old promo image (which I believe they did, it’s similar to a shot used for a group photo in season 2 or 3), thus had to photoshop the new Ethicure embroidery and ID badge into that old image, and it was easier to do so by horizontally flipping the image. I dunno, it’s weird. Dear graphic design people working for the show, viewers like me with a keen eye notice these things, ya know?
Aaron and his weird midlife crisis is persisting. He’s hiding out in his garage, working on all sorts of odd and uncharacteristic crafts projects. And now that he’s no longer actually physically present as hospital president, people come to his home to seek his advice.
Audrey is the first to drop by, asking him to utilise his presidential clout to help with her insurance company issue for the facial reconstruction patient. Aaron grudgingly agrees to call the insurance company, but he tells Audrey it won’t help, it will only make Salen angry and vindictive. (And it turns out Aaron will be right.)
Audrey asks Glassman, “Since when are you so defeatist?” He gives her a look. “Since I was defeated?” Glassman’s probably been playing the company takeover game one too many times to know which fight is worth fighting. And apparently this one isn’t.
Next person to come see Glassman is Shaun. He likely needed to make sure that Ellen delivered his message. Which she may or may not have — though even if she did, Aaron is not answering his phone or checking work e-mail.
“You need to come back to work and help me stop her from making all these terrible changes,” Shaun pleads. But Aaron isn’t interested. He’s stomping on grapes. Like, literally. He has a huge wooden vat with red Zinfandel grapes in his garage and is treading on them. And he invites Shaun to come help.
I’m actually hugely surprised that Shaun lets himself be persuaded to take off his shoes and socks and climb into the vat. Shaun has this thing with not liking grating things between his toes, right? Isn’t this exactly that? Though I think this bears witness to something he mentioned before, and it’s yet another callback to 4×08 Parenting, the exact scene I quoted further up. When Shaun talks to Lea’s parents at their hotel, he mentions how Lea encourages him to try new things, even though he already knows he won’t like them. And since Aaron means so much to him, he agrees to give it a try, even though he knows he won’t enjoy it.
That’s a huge sacrifice Shaun’s making here for you, Aaron. I hope you know that. But somehow I don’t think you do. Because otherwise you wouldn’t be dismissing Shaun so callously. Another ‘wtf, Aaron?’ moment right here. Because wtf, Aaron?
Actually, multiple wtfs. Firstly, stomping grapes?! Wtf? Making wine at home is not something you decide on a whim. How does Aaron figure he could compete with actual wineries on this and produce something exquisite or even drinkable? Secondly, pressuring Shaun into something he’s clearly uncomfortable with? Wtf? Thirdly, asking Shaun to step into the vat without washing his feet first? Not that I really know anything about grape treading, but that seems unhygienic to me. Wtf? Fourthly, Aaron is not even acknowledging Shaun’s predicament or offering any kind of helping hand. Wtf, Aaron?
Like, sure, I get that Glassman is going through some kind of personal crisis. He’s adopted a ‘hell if I care’ attitude, and that seems to include literally everyone. Including Shaun, whom he should be treating like a son, who he knows has special needs, and whom he has always made allowances for. Not anymore, though. Why is that?
The only way I can explain this is that this is Glassman’s misguided attempt at cutting Shaun loose. Or maybe also cutting himself loose. Shaun’s getting married, and somehow Aaron seems to figure that means Shaun won’t need him anymore. He now has Lea, and Aaron is second fiddle, or maybe even seventh or twelfth fiddle. Maybe he reckons it’ll hurt less to actively cut Shaun out of his life rather than having it forced on him.
The thing is, though, I think Glassman’s view is obscured by the rain clouds of his own downfall. Because I just can’t see Shaun wanting to ever push Aaron out of his life, conscious or unconsciously. He’s like a (excuse my French) goddamn father to Shaun. Sure, Shaun flew the nest somewhat when he and Lea decided to get married, but you don’t stop loving your parents when you tie the knot. And it’s not like the marriage will suddenly be a massive turning point that affects how Shaun will treat Aaron. It just all seems so puzzling, and it’s hard to make sense of.
My own confusion is mirroring Shaun’s, and I love that Shaun is actually giving Aaron a good talking-to. “You don’t love tying flies, or woodworking, or walking on grapes! But you used to love doing your job!” He then picks up his shoes and takes off down the driveway on grape-stained bare feet. And Aaron’s look that trails Shaun doesn’t fill me with a lot of hope that he’s gonna come to his senses any time soon. Sigh.
Side note: Interesting to note here is that the show’s autism consultant advised them that Shaun would absolutely not step into the grape vat, and they should have instead had Glassman offer up his begraped foot to Shaun to touch. It’s one of the few instances where the writers didn’t take her advice, and I’m happy to know that my initial reaction as to why on earth Shaun would be willing to get into the vat wasn’t all that misplaced.
What I also didn’t realise until Melissa Reiner mentioned it in her video was that this is apparently a tribute to a scene from the old sitcom I Love Lucy, which had a grape stomping episode. Since I’ve never seen that show, that reference was lost on me.
Person number three for a Glassman house call is Marcus. Aaron has now moved on from grape stomping to Jackson Pollock-style artworking. “A retired neurosurgeon taking up wood-working is cute, wine making is a sad cliché, but abstract painting… that’s a cry for help.” Yep, I think Marcus has the right idea.
What Marcus actually wants is advice for how to handle Salen. Which is interesting, because Marcus seemed to be doing just fine on his own. And Glassman finally says something here that sounds like it’s meant to be sarcastic, but beneath the surface might not actually be that. “It’s supposed to help me forget how much I miss working with you so closely every day.”
Next house call is Lea seeking out Glassman, one of the many private Glassman consultations in this episode. I was hoping it would be the opportunity that a lot of us have been waiting for, but sadly it was wholly unfulfilling — this much anticipated Lea & Glassman 1-on-1 scene.
Lea finds Glassman in his front garden, this time he’s planting mammoth sunflowers. They go from Glassman insisting that he’s fine to Glassman insisting that Shaun is fine. “He’s got a new fiancé, he’s got a new boss, he’s planning a wedding, he’s anxious — I would be, too.”
Yes, Shaun is anxious, and Lea doesn’t want to complicate things by bringing up the Marcie topic with Shaun. And she wants Glassman’s advice on it. This, for once, actually marginally captures Aaron’s attention. “Okay, that’s interesting,” he remarks. But not unreasonable.
Lea is concerned that Marcie’s presence at the wedding will be disruptive, and she wants Glassman’s take on whether she’s selfish, unfair, paranoid… Aaron is done giving advice, however. Like… he’s totally a 100% done. “That’s it, you’re not gonna help?” Lea asks. “No, I’m not,” he confirms.
I don’t get it. He really doesn’t care about Shaun and Marcie and how that might get super complicated, particularly on Shaun’s wedding day? How has he become so blasé and dismissive? What the hell is going on in that stubborn skull of his? I’m stumped. And I wanna shake some sense into him.
Kinda hate that none of the really important topics were raised (engagement party speech, Glassman’s father role, Shaun’s recent meltdown, …), albeit very obviously Glassman, right now, doesn’t seem to be receptive to any kind of actual meaningful conversations. There’s still so many elephants in the rooms that should be addressed. Whom do I need to bribe to still see this happen in season 5?
Daniela said to me that she’s starting to believe that they don’t have any interest in covering the father-son aspect of the Glassy & Shaun relationship. There was absolutely no mention of it. She was half expecting Lea to call Glassman out on that, to tell him something like, “He’s going through so much and now he’s also losing the only dad he’s ever had.” But nothing of the sort was forthcoming. So I’m not the only one both confused and somewhat frustrated by the whole thing.
The Second Year Residents
Jordan is taking personal training lessons at a new gym, and she’s into Rafael. He knows just how hard to push when stretching you out.
Jordan and Asher get into an argument about religion when the topic of downsizing the hospital chapel comes up during surgery. Asher compares praying to wasting your time by turning to a magic man in the sky for help. Jordan is actually offended by this.
This conversation continues over lunch in the cafeteria, and Asher won’t back down on saying praying is stupid and pointless. Jordan finds his stance offensive, and rightly so. Having a differing opinion on aspects of religion is one thing, but saying the other person’s opinion isn’t valid is offensive. Not one of Asher’s best moments.
They make up in the OR when Lim gives them a bit of a reprimand, or rather an eye-opener. To Jordan, she says, “You know religion hurt him. It’s what separated him from his family, that’s the context of his disdain for it.” She turns to Asher. “And you know her prayers aren’t pointless, that they offer her comfort from the pain in her life that’s just as significant as yours.” That’s a really beautiful speech and bridges all the gaps.
Asher apologises to Jordan — sincerely this time. She accepts, and then she invites him for a drink. Shaun is also game. “Tequila. Stat.” They all have victories to celebrate!
Jordan and Asher getting their duet groove on to the karaoke version of Marvin Gaye’s Ain’t No Mountain High Enough is the most epic win of this episode. No, wait, I think Shaun’s server room tirade will have to take first epic-win place, but this is a very close second. Plastered a huge smile on my face. Absolutely loved it, and Bria and Noah knocked it out of the park. High fives all around! (Bria Henderson posted a behind-the-scenes video on her Instagram that has a bit more of the karaoke, if you’re interested.)
Mateo now has his own place, and Audrey is complaining about the lack of furnishings and amenities. She suggests he should put up some art on the walls and get a couch, and more importantly, a coffee maker. But Mateo has expensive taste and lacks the salary to match it. At least he has a flatscreen television you can watch from the bed.
Audrey is still concerned that Mateo will clash with Andrews, and she asks him politely to keep things civilised. “I’ve worked with trust fund donors and dictators. I can manage Andrews,” Mateo assures her. Why do I have a feeling he won’t?
Things don’t actually go terribly between Mateo and Marcus, but it does get a bit prickly at times. Mateo has been working too long in a renegade environment. And Audrey is the one to lay it out to him. “Think maybe your real problem is that you’re not used to having a boss?”
I’ve been asking for more Alex and Morgan moments, but did they have to be about farts? Cause apparently Morgan has flatulence after eating tacos, and she didn’t want to fart in front of Alex, so she was tossing and turning all night. She confides that to Jordan, and then find out that Salen was on the other side of the lockers the whole time and listened in to the whole conversation. (P)Oopsies.
As awkward as the whole fart party is, what I like about it is that it softens Morgan, and shows that she’s actually human. I think we’ve all been waiting for a long time to get a glimpse at that. Alex is down with it, too. I liked the idea of #Parnick from the get-go, but now I’m really digging it.
Salen is again all about the unsolicited advice. “First time I sleep over at a guy’s place, in the morning, while he’s in the shower, I go in, take a seat on the toilet, drop a deuce. Really separates the men from the boys.” Ew. What is it with Salen’s turd references? Remember the cream cheese frosting on poop?
But coming back to Morgan, I love that Audrey is done giving any shits about whom she pisses off or not. Because she tells Morgan outright, “You’re afraid that Park won’t be as turned on by the ‘real you’ as he is by the façade he started sleeping with.” Yep, that may be the root of the problem right there.
Marcus is really rocking this whole hostile takeover thing. I have a huge amount of respect for him, because he knows just which buttons to push when, and whom to bow down to to get the results he wants. That’s a truly unique and desirable skill to have. If anyone really has the handling of Salen down to a tee, it’s Marcus Andrews. Guess he learned valuable lessons from his short stint as hospital president, after all.
When Audrey comes to Marcus about Salen, he has more wisdom to share. “People play the roles you cast them in. Make her an adversary, that’s how she’ll act.” Audrey isn’t so receptive. She confronts Marcus about casting Mateo in the role of resident, hoping he’ll play along. Marcus isn’t so chill with Audrey advocating for her boyfriend, though. If Mateo has a problem, he should come to Marcus directly.
Glassman’s advice must have inspired Marcus in some way, because he is now becoming the master at pushing all the right buttons for Salen to get what he wants. Or rather, what they both want. Kinda like what Glassman did, actually. He’s offering Salen a tit for tat deal. Allow them to do Mateo’s surgery, and all of them will gladly be doing 50 high-billing knee replacements thereafter.
During this conversation, he gives Salen a good look. “Not everyone’s on board with the changes you’re making here. You’ll need allies.” So Marcus is now selling himself out, huh? That’s one way to get through this transition. Maybe a path of least resistance. Not necessarily the one with a lot of integrity.
Mateo is also impressed with how well Marcus handled Salen, and he’s not shy to tell him that. Marcus explains, “I’ve learned a few things about how to deal with administrators. But when it comes down to ‘us versus them’, I’m a surgeon.” So what about that ally spiel? What side are you on now, Marcus?
I think I’m gonna retire the Ethicure speculation now. Three episodes in, I think it’s pretty clear where this is going. Part of me loves it, and part of me hates it. But overall, I’m very intrigued with this Ethicure plot, and I think it’s invigorated the show in the best possible way. As much as we want to hate Ethicure’s disruptions, the overall introduction of this story arc gets two thumbs up from me.
I’m still trying to figure out where they’re taking Glassman this season. I will admit I may have been wrong about the whole alcohol problem direction that had been suggested early on. I wouldn’t dismiss it entirely that it may still rear its ugly head as the season progresses, but right now it seems less likely.
That said, Zinfandel = wine = alcohol. Glassman wasn’t actually seen drinking any this episode, but it was still mentioned that he had more than a passing interest in producing his own alcoholic beverages. Maybe I’m grasping at straws.
And don’t get me wrong, it’s not that I want to see Glassman turning into an alcoholic. In fact, I would prefer that he didn’t, because it would likely do all kinds of damage to his relationship with Shaun. For a hot second, I was excited about the prospect of the friction and the emotional intensity, but I’m also cool if they don’t actually go there.
Whatever they’re trying to establish with Glassman, the jury is still out what the intended end game of all of this might be. Something’s clearly amiss, and it has already jammed a wedge in between him and Shaun. So what does that mean for the wedding?
If I recall correctly, David Shore hinted at the fact that Glassman would take on the role of father of the groom at the wedding. Reading all the signs, it seems the most likely scenario that the wedding will be the mid-season finale. And assuming that Glassman will not taint the wedding by being all weird and distant and devil-may-care, this whole thing will have to get resolved before then, so I guess over the course of the next three or four episodes, maybe? Seems like there’s still time for us to see some good stuff coming our way. Fingers crossed!
State of the Shea
If you wish to read more episode insights from fans, I would recommend you check out Kelli Lawrence’s State of the Shea Pt. 43 post that has a lot of really good analysis and her own views of the episode and our favourite couple.
I’ve written missing scenes in fan fiction form to glue together or expand on what we saw in this episode. Feel free to check out my fanfic titled ‘It’s Hard To Dance With A Devil On Your Back’ that I’ve posted on AO3 that’s a collection of gap fillers for all the season 5 episodes aired so far.